Provider Demographics
NPI:1417348442
Name:JOHNSTON, LESLI HIGGINS (MS/CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LESLI
Middle Name:HIGGINS
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9328 WAKEFIELDS OAK GROVE DR
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-7338
Mailing Address - Country:US
Mailing Address - Phone:919-215-0237
Mailing Address - Fax:
Practice Address - Street 1:9328 WAKEFIELDS OAK GROVE DR
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-7338
Practice Address - Country:US
Practice Address - Phone:919-215-0237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3518235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist